In a recent study analyzing HIV surveillance data in eight jurisdictions, including Massachusetts, African immigrants accounted for 0.6 percent of the population, but 3.8 percent of those diagnosed with HIV. African immigrants have a higher rate of HIV, present at a later stage of HIV disease, and experience greater HIV-related stigma. Language, culture, immigration status, and health literacy often are barriers to prevention and HIV care. There is an urgent need to identify and compare service delivery and intervention models that effectively screen, treat, link, and retain African immigrant patients in care to achieve viral suppression.
The Africans for Improved Access (AFIA) program at the Multicultural AIDS Coalition (MAC) started in 1999 as a community coalition and now serves as an HIV screening, prevention, and advocacy program engaging African immigrants in Massachusetts. Community engagement is at the core of AFIA’s work. The end result not only achieves AFIA’s goals of increasing utilization of HIV services and reducing new infections, but also leads to more sustainable initiatives that are rooted in the community. Our project is led by a five-member partnership team consisting of two African immigrant patients, a community advocate (indigenous to the community), a clinical researcher, and a government senior director, each representing key organizations in Massachusetts’ HIV services landscape.
The goal of our proposed Tier I project is to build capacity and engage diverse stakeholders in defining areas of need and priorities for addressing HIV among African immigrants, and identifying research topics that can lead to a patient-centered CER question. Tasks and activities will support (1) establishing an equitable partnership committed to developing a CER project addressing HIV among African immigrants; (2) developing an iterative, collaborative process for engaging diverse stakeholders in identifying barriers and facilitators in engaging in HIV prevention, screening, and care for African immigrants; and (3) defining a patient-centered CER question for Tier II through prioritizing a topic within HIV screening, linkage, care and retention.